Reader: A path backward to institutional care and segregated services

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The United States Senate is moving rapidly toward a plan to cut and cap the Medicaid program, which will be devastating to people with intellectual and/or developmental disabilities (I/DD) who rely on Medicaid for home- and community-based supports. Colorado receives over $625 million dollars in federal funds to provide supports and services that individuals with I/DD use to live in the community.

Over the last two decades, funding for home- and community-based services has grown because of widespread bipartisan support. These services have had bipartisan support because disability knows no political, geographical, ethnic or socioeconomic boundaries. They provide dignity to people with I/DD through assistance with meals, bathing and dressing, toileting, in-home skilled nursing and communication support, among other services.

The Senate is considering the same $880 billion-dollar cut to the Medicaid program that was passed in the House. We fear that because home- and community-based services are "optional" services, states will cut them first if confronted with this greatly reduced federal commitment. States may return to outdated modes of serving people with disabilities, congregating large numbers of individuals in facilities with inadequate staffing and no real-life opportunities. The proposed per capita cap will pave a path backward to institutional care and segregated services.

We must call on our senators to protect Medicaid and to continue the 52-year commitment to providing health care and long-term services and supports to persons with disabilities.